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Shattered Talus Report / Analysis
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By Vincent Morton
From Colorado Springs,Colorado
Apr 5, 2012
belay is on
Congrats Ben, Glad to hear you've healed up! Still waiting to get my cast off, I guess what Im trying to say is, im jealous...

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By Bruce Pech
Apr 27, 2012
Pinnacle Gully: Mt. Washington 1974  Chouinard ice...
I'll add a less than cheerful data point to this thread. I fractured my calcaneus and cracked my talus in an unroped, 12' fall 10 years ago at the age of 57. I needed two operations a year apart to sort out the mess -- the first to correct the displaced fractures of the heel and the second to remove a metal plate that was impinging on a tendon and making walking difficult. Despite the surgeon's cheerful prognosis, approach hikes or backcountry ski trips on rough terrain left me in disabling pain at the end of the day (and for another day or two afterward) so I consulted a local podiatrist. After x-raying my ankle, she diagnosed the problem as severe traumatic osteoarthitis of the subtalar joint and said that little or nothing could be done to correct the condition. She was right -- I've had to give up ski-mountaineering, backpacking, and approaches longer than, say, the distance from the old McGregor Ranch parking lot to the Bookmark and Bookend.

Oddly enough, the arthritic ankle had very little impact on my actual climbing. Until I had a knee replacement last fall, I was able to lead multi-pitch 10s and 11s with no more than a dull ache in my ankle. Now I'm waiting to see how a metal and plastic knee affects my hiking and climbing.

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By JamesMichelinie
May 9, 2012
Brice, good luck to you. It sounds like you have the right attitude and you're in the right hands.

A general thought to all of those who are considering ignoring the doctors advice. Unfortunately, this is, as has previously been mentioned, a very serious injury with potential for life changing complications. It's one thing to break your wrist or have the flu or something and push it when you're told not to. Worst case scenario is you take a little longer to be back to normal, but at least you had fun doing it...right?

In the case of talar injuries, if you end up with severe avascular necrosis of the talus, there is no recourse. The bone will be removed and you'll end up with an ankle fusion. At that point nevermind not being able to run, you definitely won't be able to climb and probably will have trouble walking. That is not the worst case scenario. It's not uncommon for the end game of AVN to be a below knee amputation. The thought of not running or a long recovery might be daunting, but you are still young, and still healthy. There are many ways to continue to enjoy the outdoors. If you end up fused or amputated, your options become seriously limited, and those procedures will dramatically effect not only your hobbies and passions, but your daily life!

If you're unhappy with your recovery plan, seek a 2nd opinion, but don't ignore your surgeon. He is likely very smart, educated and experienced and does have your best interest in mind.

For reference, I am not a doctor, but I am a biomedical engineer and I design orthopaedic implants for the foot and ankle. Specifically devices to treat ankle fusion...

Good luck to you.

-James

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By Stuart Teague
May 10, 2012
I'm happy to report I returned to running at the 6 month point from my fall. I have run a few times in the last week, and while my right ankle hurts and swells, further improvement is on the way. I saw the surgeon yesterday, and my X-ray showed no signs of AVN. There is a delayed risk of it up to 10 months out so I have one more X-ray. I don't know how the doctor fit that many screws in such a small bone without destroying the blood supply.

I have stopped worrying about what might happen though and have concentrated on doing what I want to do. I started climbing at the gym with the cast at 4 weeks and started leading sport with a stick clip at 5 months. I led 3 gear pitches of a slab at Looking Glass last weekend and got in 4 days of skiing this winter.

The ankle does hurt, but the pain is in a lateral tendon on the outside of the foot. The doctor said to get a wobble board thingie that was developed to treat weak ankles.

I did a lot of reading on the Internet while I was in the hard cast. There are a lot of positive outcomes for talus breaks. There is at least one friend of a friend who supposedly climbs 14 with a fused ankle.

All I know in the end is that I'm 47 with a stiff ankle. The injury has taught me never to take mobility for granted again. Live each day like it is your last and don't dwell on negative possibilities.

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By Bruce Pech
May 10, 2012
Pinnacle Gully: Mt. Washington 1974  Chouinard ice...
Stuart, Sports Authority sells "wobbly board thingies" (a disc with a curved bottom) for around $35. My physical therapist recommended it as one of my post-knee replacement rehab exercises. Good luck.

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By JSH
Administrator
May 10, 2012
JSH @ home  photo courtesy of Gabe Ostriker
Stu, keep working on it. There are two wobble boards that I can think of that will help.

First, my PT had a wobble board that was flat on top with one ~6-inch diameter half-ball under it. From a sitting position with your heel in the middle, you use your foot to rotate the board around. This helps with flexibility and joint motion.

Second, my PT also has me on a "bosu ball" which is a ~2-foot diameter rubber flat circle, on which there's a half-ball mounted to the entire thing (look up "bosu ball" on Amazon). Doing step-ups (step with one foot in the middle, bring other knee to waist height), and balancing on either side, has been great to build active strength along with flexibility.

My peroneal tendon on the left subluxes (pops over) the outside ball of my ankle, so it's not as strong as it should be. I may or may not have that repaired in the future (after 4 surgeries on the foot, I'm all set with crutches ... ;)

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By Bruce Pech
Jun 7, 2012
Pinnacle Gully: Mt. Washington 1974  Chouinard ice...
I'm not qualified to give you a medical opinion (although it strikes me as odd that your doctors are leaving bone fragments in the arthritis-prone subtalar joint), but I can confirm that weight-bearing three months after surgery to repair displaced fractures of the calcaneus and a cracked talus was extremely painful.

If feasible, ask for a second opinion from a well-regarded orthopaedic surgeon in Oslo or elsewhere in Norway before travelling to the US for surgery. Unless your Norwegian medical insurance covers out-of-country surgery, surgery coupled with a brief hospital stay is likely to cost a minimum of $10,000 USD. Good luck.

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By Lzpup
From santee, ca
Jun 22, 2013
bio
Great, thread. I broke my talas on a lead fall to a ledge. Poor reading of multiple xrays and my bull headedness, no surgery. I have a floating bone piece and pretty bad osteoarthritis , one doc said it was from the trauma and surgery would not have mattered, but would have preferred the choice. I would tell anyone who hits a ledge, to get a CT scan and/or MRI, takes a decent doc to see some of this shit on an xray right away due to swelling. Anyway , it's been a year, back to rock climbing and have hit some harder routes on Shasta and 2x rainier. Real heavy boots are the key for me, and Ibu for the way out. I just got a cortizone injection for my last attempt on Rainier (turned around for someone else in party (400ft shy)), i can say it helped alot and will consider for my big projects, much better recovery. Usually i am dying after a big slog with 70lb pack and thousands of feet, but this time not so bad.
I am fairly new to rock climbing, so hard to gauge impact, I am climbing better than i did before the accident, but this is due to learning. Some days my ankle gets tired and sore, i think a lot of this has to do with rebuilding the strength. Hardest part of this injury is getting in enough training , can't run and afraid of the stair machine. Lots of Mountain biking and surfing , but hard to replace the calorie burn and quickness of running, definitely put on some weight. I need to see another specialist, the thing im struggling with at the moment is how hard to push it, I still have some projects i want to do and need to raise the fitness bar.

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By Dom Horath
Nov 21, 2013
oh man this is a crazy but really helpful formum. I just shattered my talus 5 days ago. Yes,shattered. As in the doc said "I count 3 big pieces and about a dozen or more tiny little pieces." I still wasn't sure the implications of a talus fx so I was kinda like..great, well can I climb again in like a few weeks or so? Sounds like it's gonna be a long road to recovery...

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By ben smith
Nov 22, 2013
recovery is a long and rocky path, but its the only one....so give it your best shot. its my second year back to climbing status post talus fx (see my previous posts). things were quite grim after my fx with the delay in dx, tx, and all the horrific things to read about on the internet.

consequently, the most challenging part for me has been getting back on the sharp-end and climbing again. its taken many leads for my psyche to get into a good place, if not better. i am more cognizant of everything....almost to a fault, but i am climbing smarter and harder.

yes, i do have more pains in my ankle and approaches and descents are taxing. i no longer run (not that i enjoyed it that much), but no cycle for cardio training. i know that i have osteoarthritis and running or other "high-impact" activities will exacerbate my osteoarthritis. so, i have decided that i want to enjoy climbing to a ripe old age. therefore, im not "running it-out", like i used to. im not taking big risks. but im still climbing and having fun

your attitude through recovery will determine much...

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By Ted Eliason
From Westminster, CO
Nov 22, 2013
First lap on Mixed Emotions
If it's any consolation, I'm two summers past my Talus fracture. I'm back to leading sport routes in the 10's and trad routes in the 8's and 9's. I ran two trail half marathons this past summer. I did have a follow up surgery to remove scar tissue and add mobility last Nov. The scar tissue that remains still causes limping in rest periods following exercise, but once the foot warms up it is pretty functional for anything I want to do now.

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By JohnnyG
Nov 22, 2013
My talus fracture is still getting better, 14 years after the fall, as I wrote upthread.

Not sure if that a good thing (it's still getting better) or a bad thing (it still limits me somewhat). But i'll take the optimist point of view...it's a good thing!

Oddly - there is a medical paper calling this the "snowboarders fracture." From the looks of this thread, it could also be called the climbers fracture.

Anyway, good luck with the recovery to all.

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By Dom Horath
Nov 22, 2013
Thanks for the reply guys...it's really comforting to know that there are climbers like me who have gone down the same path. I unzippered a pitch so as they say...could've been worse right. i'm going to buy a hangboard to keep the tendons strong.
peace,
Dom

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By Bryan Thomas
Jan 25, 2014
Top of Libery Bell near Washington Pass
Just fractured my Talus two weeks ago, wow the surgery hurts a heck of a lot more then actually breaking of it. It's been a week and I still can't stand up on my crutches with out the ankle swelling up. Funny thing is, I actually broke it snowboarding. The first thing I thought about when I felt it break was how this is going to effect my climbing and will I be alright for this summers climbing season. I've also just hurt my shoulder a few months ago, the doc says it's bursitis...hopefully it just goes away. Feeling pretty discouraged right now, but it sounds like there's a lot of other people on here that have gone through plenty of other injuries.

Good luck to everyone else out there are on the road to recovery!

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By Dom Horath
Feb 6, 2014
Bryan-
Sorry about your accident. I'm sure it depends on where you break it and if it was displaced or not, etc. but just as a time frame for you, I am quickly approaching months 3 since the accident (I did wait a week for surgery though). I am now walking around with a boot and only use crutches here and there. maybe another month until walking again without the boot. so 4 months total until walking since my accident. I'm hoping 5 or 6 until surfing and climbing again. good luck. I totally shattered mine though so maybe yours won't be as bad? just take it really easy and once you go from a cast to a boot I would start asking about PT. Are you using a bone stimulator? these are great if your insurance will cover it. because of the threat of AVN (avascular necrosis) with the talus I would look into it.
good luck,
Dom

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By Michelle Boyd
Jun 9, 2014
I have a similar story to probably many people here. I was indoor bouldering (that's rock climbing with no ropes for those of you who don't know) it wasn't a very hard wall but I was tired from climbing for a while so I lost my grip almost at the top of about a 10ft wall. So I fell and some how my right foot went snap on the landing and twisted to the right. Once on the mat I didn't actually realize the extent of my injury until I tired to get up. Once I looked at my right foot it had swollen almost instantly to the size of a softball. My friend rushed me to the emergency room near by and I found out that I had shattered my talus bone. The image I saw later of the bone just looked like a bunch of little pieces of confetti. Thankfully the bone didn't move out of place just completely shattered.
So I to went to see many different doctors until I got my podiatrist who recommended we don't do surgery cus the bone wasn't out of place. After 3 months of being in a cast my doctor told me I should start putting weight on the bone.

Sadly that proved to be a very bad idea. My bone that healed resplit and I was forced to go back to square one. No weight and elevation at all times. I also started bone therapy 30 mins a day where I put my foot in this machine that helped to stimulate bone growth. Now the bone growing didn't actually hurt but I was incredible uncomfortable.

All in all I'm just saw my doctor and it seems that the part that resplit still hasn't filled in again after another 3 months. So to sum it up I've been in a cast for 6 months now and still looking at another month in a cast. Surgery might be in my future unless my bone shows some growing process.

Not many people can really understand things like this that people go through. This journey has been very difficult basically rearranging your whole life. The first couple months were by far the hardest. The emotion toll it takes is like walking through a tunnel with no light at the end. Everyday you have to tell yourself things will get better and so days you believe it and other days you don't.

So here I am still hoping for the best on this 6 month long life changing journey. Wishing everyone going through similar problems that they don't lose hope.

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By KenSnow
Jun 18, 2014
First of all, thanks to everyone for this thread...I'll add my story to the list here as well. I broke my talus bone on a lead fall to a ledge almost a month ago now. The real shit kicker here is that I broke it two weeks before going to Yosemite for my wedding (my fiance was none too pleased). Initial trip to the ER was a mis-diagnosis as a sprained ankle, they didn't spot the break in the talus due to the angle of the x-rays. I followed up with an ortho specialist and they spotted the bone was slightly out of place. The MRI revealed that I had done a good job of shattering my Talus. It ended up in 3 major pieces, and some conffetti in there for good measure.

I had an ex-fix put on temporarily to allow for the swelling to go down and so that we didn't have to call off the wedding. 2 weeks ago I had another surgery which removed the ex-fix and added 2 screws to my talus (ORIF open reduction and internal fixation). The thought of avascular necrosis (AVN) scares me...at a relatively young 30 years of age, I have a lot of plans for that ankle and would be devastated if I were unable to enjoy hiking and climbing.

I have the stitches from the surgery removed soon and will hopefully continue to heal up. Right now I don't know specific expectations with my recovery.

Self Rescue & backpack splint
self rescue
self rescue


Exfix
exfix
exfix


Post ORIF
ORIF
ORIF


Long overdue follow up. I have been weight bearing since September, back to short to moderate hikes (about 7 miles), and mountain biking. Due to my chaotic summer (traveled abroad, moved across country) I have not yet started PT, but will start soon. I am not back to climbing yet as I am still getting settled here in Salt Lake but plan to get into a gym over the winter.

Ultimately my healing went better than expected. The talus head/neck was intact so there is low likely-hood of AVN, probably get some serious arthritis in a few decades though. The two screws fused my talus well, and I have not had any complications yet...just a looong recovery.

While all broken and on disability, I had the fortune of staying at my parents camp on a lake, and would routinely swim over 1mi. around a small island (with a spotter) to keep in shape and prevent atrophy. I highly recommend anyone to swim as much as possible as soon as the surgery scars heal up.

Good luck out there!


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By bmdhacks
Jun 18, 2014
KenSnow wrote:
The real shit kicker here is that I broke it two weeks before going to Yosemite for my wedding (my fiance was none too pleased).


Hah, I shattered my talus four days ago. Wedding is in 10 days.
So how'd it go?

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By KenSnow
Jun 24, 2014
I am happy to report that the wedding did indeed actually happen, and somehow I managed not to destroy my erector set ankle after all the drinking and crutch hopping/dancing. :)

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By Mark Maltese
From Columbus, OH
Aug 11, 2014
Hearing the stories in this thread has helped me deal with my injury, so here my story, in hopes that it might help someone else. This past May (about 3 months ago) I was leading on some rock and took a moderate fall, nothing too large, maybe 12 feet. Two pieces of pro zipped out of the thin crack and the jerks from the gear catching and popping made the fall unclean, causing me to take the brute of the fall on my right foot. I immediately knew something was wrong and couldn’t put any weight on the foot. I was lowered and luckily had some great friends with me, who served as my crutches as I hopped and crawled out of the gorge and back to the car. I was out of my home state and about a 4 hour drive from my primary hospital, so I ordered a few pitchers of beer before enduring the long drive to the ER. We got in really late, around 3 am, and I had an X-ray done. The ER Doc came in and told me the X-ray showed no breaks— I just sprained my foot and it should be better within a couple weeks. She gave me two days worth of hydrocodone and 14 days worth of 600 mg ibuprofen. I was in an ace bandage and unable to really move my foot for the first week, but gradually I started doing range of motion exercises and kept taking the ibuprofen. Looking back, I wish I never took the ibuprofen, as I have now found out NSAIDs can inhibit bone repair. I was on crutches this whole time and never really had too bad of swelling, just a yellowing of the skin around the injury, and was frustrated with my inability to climb, run, or basically do anything besides upper body and walks on my crutches. I scheduled an appointment with a sports medicine doctor 3 weeks post injury, who gave me a “walking boot” and ordered an MRI. I got an MRI one month after the injury and promptly received a call later that night, saying to ignore any previous opinions and to not be bearing any weight, even with the new walking boot. Luckily, during this entire month, I listened to my body and decided I would not attempt to walk on my bad ankle, and remained completely non-weight bearing until I got the MRI results. I went in for an appointment with the doctor the next day and was told I had a comminuted (smashed) talar neck fracture, a rare injury. In fact, he was surprised my calcaneus (heel) wasn’t also smashed to pieces. I was immediately referred to a orthopedic surgeon. After review from the surgeon, I was told that somehow, even after a month of no cast, the comminuted pieces seemed to have not displaced enough for the need of surgery and started to piece themselves back together. I was non-weight bearing for another month and a month ago I switched to partial weight bearing and am now, 3 months later, full weight bearing, without a boot. Granted I was lucky enough to not have major displacements of the talar neck, however the severe comminution makes my break a questionable Hawkins I case. I am still not able to walk 100% and am on the watch for AVN. Furthermore, the bone is stronger, but to my knowledge the fractures are not completely healed. I should find out this week.

Here is what I have been doing to stay active, as I believe as soon as you can move it, use it or you will probably lose it.

4 weeks in I began swimming twice a week, for as long as I comfortably could. I also started taking the following vitamin doses and supplements, after reading up on preventing AVN and promoting bone growth:

Morning: Calcium-900 mg, Vitamin D-1400 IU, Magnesium and zinc (which are covered in most multivitamins), Fish oil, Safflower oil, Astragalus root-1410 mg, and Cordyceps sinensis-1500 mg. The last three supplements were some of the few homeopathic items that I read might prevent AVN. Maybe it is a load of ****, but I am willing to try anything to get my ankle back.

Evening: Calcium- 600 mg, Vitamin D- 200 IU, Astragalus root-1410 mg, and Cordyceps sinensis-1500 mg

Since progressing to partial weight bearing I have also been biking at least twice a week, continuing the swimming twice a week, and have been doing PT twice a week since week 5 of my injury. The PT has helped immensely and each week I notice improvement. One of the huge hurdles is regaining lost leg muscle and movement that results from atrophy during immobilization. Be as active as you can without further injuring yourself! Also, no caffeine, as it is horrible for bone healing. I have been occasionally drinking, and still went out even when I was on crutches. Being injured is hard— being depressed and injured is harder.

This past week I was fortunate enough to go to the Tetons. Unfortunately I originally planned the trip with hopes to summit some peaks and climb some ice, but it was looking like I wouldn’t even be able to walk. I surprisingly ended up being able to walk again around week 10, just in time for the trip. I did a couple moderately strenuous 7 mile hikes, which resulted in a sore ankle and some pain, but hope that a broken talus may not permanently eliminate mountaineering from my future. I am still at risk for AVN and have an appointment to check for it this week, but it is important to keep looking forward. A fusion, or even an amputation, doesn’t necessarily mean an end to climbing, but it will sure as hell necessitate a need to dig deep, mentally and physically, in hopes to overcome adversity.

Update: After 4 months of healing and lots of physical therapy, my ankle is about back to where it was (90%). I can do basically anything I used to be able to with it, with minor discomfort, although running long distances does take its toll. On the bright side, face climbing and foot jams are back to where they were! Best of luck everyone, just keep in mind it does get better, and I'm still noticing slight improvement, even 6 months later.

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By bmdhacks
Oct 1, 2014
Just an update on my shattered talus. Three months ago I shattered the lateral process of my talus into 10+ pieces. This is sometimes called the snowboarders fracture. However the talar head and body were fine so blood flow wasn't a concern. But because the small lateral process was in so many pieces nothing was big enough to put a screw in.

Three months later all the pieces have fused as if you dumped a broken glass bottle into a box and squirted hot glue in while shaking it up. So I have bone volume, but it's full of sharp edges. The end result is pain when I push down with my calf muscle. I can still climb in a half-assed way on toprope, but I walk with a limp and it's not getting better.

So next week I'm scheduled for surgery where they're going to grind off all the sharp edges. Then another two weeks on crutches again.

There's a lot of hardcore people with unshakable constitutions, but I'll have to be honest this is really hard for me. My fitness level is shit, and I'm just barely keeping depression away with with seated rows and pushups.

I'm writing this down here so that when my update in 6 months comes with me hiking the PCT or something, others can get context that it's temporary.

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By Caitlin Mac
From Tempe
Dec 1, 2014
Ball Pass NZ
Fractured Talus injury 20 minutes after falling 10...
Fractured Talus injury 20 minutes after falling 10-12 feet onto lots of rocks


1 week after the accident
1 week after the accident


After searching on Google, talus fractures, I came to this thread and realized my injury must be pretty common for climbers.. So here's my story.

Written on DEC 1, 2014

Well, last week, I was in South Africa on a 2 month climbing trip when I fell on the final pitch of a 1000 ft. I was starting off a big ledge, and as the climbing was easy, I had not placed any gear when the big jug I was holding onto broke. Here is what my ankle looked like right after the injury, and 1 week later. Originally they also told me it was just soft tissue and I would be out of a splint in 2 weeks. The second doctor realized there was a fracture and some chipped bones. Now, 9 days later I am finally learning (after flying home and ending my trip over a month early) what happened. I am also just beginning to realize that the talus bones is the worst bone to break.. I have a cat scan tomorrow, and a follow up 4 days later to determine if I need surgery. Any advice on if screws are the way to go or not? My doc was hoping I wouldnt need any surgery, but Ill be able to update tomorrow after the CT..

Any advice that will help me get walking/running/climbing/alpine climbing again ASAP is welcome.

Thanks

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By Paul Hunnicutt
From Boulder, CO
Dec 1, 2014
Half Dome
This is the WRONG thread to get psyched on climbing! This thread makes me want to find a new sport altogether...as if I didn't already have enough reasons.

Best of luck healing! Thanks for sharing how even a small fall can dramatically impact your life.

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By ben smith
Dec 1, 2014
Have faith!

It has been just over three years since I broke my talus and lamented my desperate concerns in a post on this thread. While my ankle is not what it used to be, I most likely finished my last pitch of rock climbing for the season today and am looking forward to ice this season.

In fact, I have more FAs and wilder experiences status post my talus fracture. For me, the hardest part was keeping a positive attitude and having faith that everything would be all right. Especially after doing an internet search on talus fractures....that can certainly grim and not helpful for your psyche.

So....have faith that it will be okay and keep your self busy!

Ben

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By Stuart Teague
Dec 2, 2014
Caitlin:

I had 6 screws placed in my right talus 3 years ago. They seem to be working. The surgeon recommended against taking them out. He said the removal surgery is just as invasive as the original work. He told me that the bone is fine with them there as long as they do not work out.

I can't say that I'm back to normal, but I climb and run on my ankle regularly. Some days it hurts so bad I wish they'd cut my foot off. But, some days I barely feel it. I have run as far a half marathon since the surgery though so I can't complain too much. The good news as far as I am concerned is that it turns out ankles aren't that important to actually climbing. You just need them for the approach! good luck!

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